Question:
My wife is about to start her own pediatric dental practice once she
finishes her residency in summer '05. In preparation, I have begun to
research various topics relating her new office.
I am a computer engineer, so one of my focuses will be helping integrate
technology within the practice. I think she has decided to go
fully computerized with digital xray machine (likely phosphor plate
system) and software to do back office charting. The thinking is that
with a new practice, if you don't start out with digital x-rays it is
very difficult to go fully digital in the future. Ideally, I would
envision that there are no charts for the patients with everything being
done on the computer. I have been looking at some various software
systems (dentrix, eaglesoft, softdent), but everyone seems to be
"selling what I need" if you listen to the sales people.
So, are we there yet? Is this a realistic requirement? Anyone doing it
with success?
How do you handle issues where a patient signature is actually required?
Consents, etc. Do you use signature capture pads, have the person sign
paper and then scan documents and store them with the chart. Then comes
the issue of backups and security, the list goes on and on.
So, what can you tell me about your fully digital office? What software
are you using, what do you like about it, what don't you like about it?
Would you have gone with a different software if starting out today?
I'll also gladly accept any words of wisdom you can share relating to
the startup of a dental practice. If you were starting over today, what
would you have done differently?
Answer:
Its a charting system that calculates the monthly budgeting fees.
You chart the mouth (slightly simpler than full clinical charting), broadly
assess perio etc and it spits out a charge band based on all the usual stuff
you would expect.
Directed towards un computerised Dentists that do paper charting (common
here) and Dentists with back office but no clinical systems.
Prints out a nice graphical report that is the basis of the annual contract.
It sold 10 on its first presentation to a local group of dentists. (I wasn't
there or it would have been less)
Make certain that your UPS will keep you up and running long enough to
call your patients to reschedule them for when you have power again.
Have paper back ups for health histories and chart writing for the
days the computer is not available. We have had to resort to paper on
at least one day. There was no problem, because we were prepared and
the staff had actually drilled for the possibility.
Have backup laptops for your chairside terminals. We had one unit
lock up in our four chair school clinic last week. We were not able
to use that chair for over an hour while the techies resolved the
problem from the server or another terminal.
I have a question for you. I've used computers for nearly 35 years.
My first programs were recorded on paper tape and punch cards. I lost
some important utilities when I went from DOS to Win 3.1; I lost more
when I was forced to go form Win 3.1 to Win 2000/XP; What of our
paperless records will we loose when we go from Win XP to the next
thing? Will we be able to do without it? Will it be something we
need?
I am not thinking about doing away with my paper charts in my office,
except for when they are misfiled.
Outside of a server hardware failure, computer issues should never shut down
the dental office. We just keep one good spare PC that was replaced during
an upgrade. Should any machine fail, we can swap out PC's, and work on a
slower PC for a day or two until the "normal PC" is fixed. If you configure
your server to function as both a server and a workstation, then you only
need 30 minutes of battery life on the server. You can close the day (and
call the remainder of the scheduled patients) from that one machine.
You do not need to keep any permanent paper records. Our software prints
out a "routing slip" for the day's appointments. It lists the patient's
demographics, insurance profile, medical alerts, treatment plan, and gives
me a place to check off what we do that day. The patient carries the form
to the front desk, who enters the data and shreds the form.
You do not lose any records as your operating system changes, unless you
refuse to update your software. A good software program will keep updating
the file format of all your data as the software evolves and the operating
system improves.
